Tenet Healthcare
Corp., which
operates 49
hospitals, has
promoted Paul
T. Browne to
chief information
officer. He previously served
as a senior
vice president
overseeing the
applied informatics department
since joining
Tenet in June,
a duty he will
retain, and succeeds Stephen F.
Brown, who will
retire in March
2013 following
35 years with the
company. Paul
Brown previously served for 13
years at Trinity
Health in Novi,
Mich., rising to
chief integration
officer. He also
spent five years
at SelectCare, a
regional insurer
in Michigan,
and eight years
as a consultant
for Accenture
and Anderson
Consulting.
New CIO
at Tenet
Healthcare

Regardless of who won the election, health care reform efforts will fail
unless the industry changes its orientation to patients. That was one area of
consensus during a panel discussion
of member organizations during the
Medical Group Management Association in San Antonio.

Quoting a patient he interviewed
following a care delivery pilot project,
panelist Allan Korn, M.D., said the
member posed a rhetorical question:
“Why do you call it a patient-centered
medical home when it takes place in
the doctor’s office?” Korn, the chief
medical officer of the Blue Cross and
Blue Shield Association, said the patient wanted the “medical home” to be
where he lived.

The medical home is one of several
models of care delivery in play as the
industry struggles to replace fee-for-service with outcomes-based pay. And
the panelists, who also represented industry heavyweights American Medical Association and American Hospital
Association, said those models would
emerge regardless of who controls the
presidency—or Congress. Yet Richard
Umbdenstock, president and CEO of
the AHA, underscored the uncertainty
over reform. While the industry understands the urgency of new delivery
models such as the medical home, it is
uncertain how to evolve to outcomes-based pay while being dependent on
fee-for-service, he noted.

No one had a clear answer for thatissue, but Korn continually broughtthe conversation back to patients. Helaid out a scenario in which the pa-tients would orchestrate care fromthe home, with some robust I. T. toolsat their disposal. Korn proceeded todescribe a patient-controlled encoun-ter. The patient would view a touch-screen record, with photos of his vari-ous caregivers on the screen. Throughthe set-up, the patient would initiatecommunication and request calls fromproviders. “If we begin to think in thoseterms, to support patients with chronicillness, our workforce will go a lot fur-ther,” Korn said.While he acknowledged the needfor new delivery models, AMA Presi-dent Jeremy Lazarus, M.D., said thatpatients still want their care to be ledby physicians. “We need to pay atten-tion of the scope of practice,” he said.Other panelists noted that consum-ers will need to adjust their own think-ing around health care if they are toevaluate what care is needed. The con-sumer orientation to health insurancealso will need to change for the newreform models to work, Umbdenstocksaid. Consumers don’t mind not filing ahomeowner claim on their house insur-ance, he said. But if they file no claimsagainst their health insurance, “theythink they are leaving money on thetable. They think of it as prepaid serviceand we need to change that mindset.”—Gary Baldwin

HEALTH REFORMIndustry Vets Struggle With Changing Landscape

WORKFORCE

Health Costs Higher forHospital Workers

New research from Truven Health wmerly the health
unit of Thomson Reuters, finds health care spending for
hospital employees is 9 percent higher than the general
workforce, and hospital employees and dependents are

5 percent more likely to be hospitalized.

“The very nature of hospital workers is to care for oth-ers, sometimes at the expense of themselves,” according to a white paper on studyresults. “In addition, hospital workers may feel that they possess the knowledgeneeded to improve their own health and don’t require outside assistance.”Hospital workers also may seek health care at competing facilities, which canraise insurance costs for their employers, who should consider structuring ben-efit plans to encourage use of the home hospital system. “For example, someorganizations have chosen to levy a $3,000 to $4,000 per-admission deductiblefor employees who seek care at a competing hospital for services that can be pro-vided in their own system, while no deductibles are charged for employees whoare admitted to their home institution.”In the study, Truven Health analyzed health risk and health care utilization of350,000 hospital employees and their dependents—a total of 740,000 individu-als--and compared it with results of 25 million employees and their dependentsin other industries. Hospital employees and dependents were considerably morelikely to be diagnosed with asthma, obesity and depression. Hospital employeesalso had higher rates of emergency department utilization and admission for arange of chronic conditions. The employees and their dependents also receivedlower preventive services. The study concludes that a health system with 16,000eligible employees could save $1.5 million a year for each 1 percent reduction inhealth risk. The study includes a 10-point program to develop a culture of health ina provider organization.